US2638901A - Surgical clamp - Google Patents

Surgical clamp Download PDF

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US2638901A
US2638901A US239245A US23924551A US2638901A US 2638901 A US2638901 A US 2638901A US 239245 A US239245 A US 239245A US 23924551 A US23924551 A US 23924551A US 2638901 A US2638901 A US 2638901A
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clamping
tube
members
face
bore
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US239245A
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Everett D Sugarbaker
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus

Definitions

  • This invention relates to surgical clamps and particularly to an improved recto-colic anastomosis clamp.
  • the present invention provides a rectocolic anastomosis clamp whereby the foregoing dif ⁇ I culties are overcome.
  • the clamp is so constructed as to allow ready escape of the mucoid contents of the bowel when the clamp is.v in place. .
  • the anastomosis clamp of the invention is also characterized by a combination of structural A features which make application and adjustment of the clamp far less diicult than has ybeen the case heretofore.
  • the clampis adapted to be assembled within the bowel, with the parts of the clamp being inserted through the..anus,
  • Fig. 2 is a side elevation offtheclamp, with the clamping members separated, partly in longitudinal section;
  • u. Fig. 3 is an end view of the lower clamping j
  • the lower clamping shank 4 having at one end an enlarged, poraber .2. -ben2 adjacent the clamping faceIZ is a pin I5 and, .toreceivejthe pin l5, the tubular ele- .ment Illfof themember I is provided withone or more longitudinal slots Iopen at' the end member-showing the clamping face thereof; andV Fig. liv-is an'en'd- View of the upperclamping member.
  • member I includes a tion 5 with a transverse shoulder t ⁇ andatthe 'other end a vbody 'I withan annular clamping iace, Fig. 3. ⁇
  • a tubular extension I0 directed-.away fromthe clamping face 3.-y
  • the lclamping. member I' comprises .a generally tubular memberwith thebody .lconstituting an intermediate outer enlargement.
  • the upper clamping member 2 comprises a.
  • Vbody II havingan annular lclamping face I2 -and'an vaxial bore I3.
  • a portionpf. the bore I.3 is interiorly. threaded at I4, and the bore .adjacent theclamping face I2 has a diameter such that .the tubular element I0 ofthe lower clamping. member I -may slide into and .t snugly within thebore of the .clamping mem- Extending into the bore I3 of the inemf portion capable .of being inserted through the bores 9 and.v I3 andhaving at one end an enlarged por-tion Il presenting a transverse shoulder ⁇ ...IILand .at the Aother end an exteriorly threaded portion i9.
  • a second clanlping ⁇ member comprising ;a 'body; portion having an" annular clamping face and an interiorlythread'ed axial bore, said second clamping 4merriber' being positioned onl said tube with its vinterinr threads engaging theexterior threads of said tubeI andv with its4 clamping face directed toward' that oi said first clamping rmernb'eriwhereby relative rotation between said tube and said second clamping member in one direction forces said clamping faces together;v -andmeans-for securing a severed bowel ed over each of said clamping faces when said faces are spaced apart.
  • a recto-colic anastomosis clamp the combination of a pair of opposed clamping members each having an .annular clamping faceand an axial bore, one of ,said vclamping ⁇ members having an extended shank terminating' in a transverse shoulder opposite the clamping face thereof, the bore of the other of said clamping members being interiorly threaded, and a central tube'extending through the bore of said one clamping member and terminating at one end in an exteriorly threaded portion engaging the interior threads of the bore of said other clamping member, said tube being provided at its other end with an exteriorly positioned stop member facing the transverse shoulder of said one clamping member, and said shank being of such length as to extend through the rectum of a patient when saidclamp is in place within the colon.
  • anastomosis clamp the combination of a central tube having at one end an exteriorly enlarged portion providing a transverse shoulder facing the opposite end of the tube, and a pair of opposed clamping members each having an annular clamping face and an axial bore, said tube being positioned within the bores of said clamping members, one of said clamping members .being provided with a transverse shoulder opposite its clamping face and facing the shoulder of said tube, and said tube and the other of said clamping members having interengaging screw threads.
  • anastomosis clamp the combination of a tube having an exteriorly threaded end portion and an exterior shoulder spaced axially from said end portion; a clamping member having a shank, a body portion with an annular clamping face and an axial bore extending through said shank and body portion, said clamping member being slidably mounted on said tube with the shank thereof extending toward said shoulder and said clamping face exposed toward the threaded end of said tube; and a second clamping member having an annular clamping face and a threaded axial bore, said second clamping member being threaded upon said end portion of said tube with its clamping face opposed to that of said first mentioned clamping member.
  • An anastomosis clamp comprising a tubular clamping member with an intermediate exteriorly enlarged portion having an annular clamping face arranged transversely of said'tubular member and exposed toward one end thereof; a second clamping member having a transverse annular-clamping face and an axial bore, said bore adjacent said last mentioned clamping face embracing said one end of said tubular clamping member, said bore also including an interiorly threaded portion; and a central tube extending through said tubular clamping member, said tube having at one end an exterior stop facing said tubular clamping member and at the other end aV portion' exteriorly threaded in ,engagement with the; interior threads of said bore'.
  • anastomosis clamp the combination of a pair of opposed clamping members each having an -annular clamping face and an axial bore, the clamping face of one of said members being provided With a. plurality of projecting annularly spaced needles and the other of said members being provided with a plurality of annularly spaced sockets to receive said needles, a central tube extending through the bores of said clamping members, stop means securing one of said clamping members against axial movement in one direction on said tube, and manually operated means including said tube for establishing axial adjustment of said other clamping member relative to said one clamping member so secured.
  • an anastomosis clamp the combination of a pair of opposed clamping members each having an annular clamping face and an axial bore, the clamping face of one of said members being provided with a plurality of projecting annularly spaced needles and the clamping face of the other of said members being provided with a plurality of annularly spaced sockets to receive said needles, a central tube extending through the bores of said clamping members with one of said members rotatable thereon, said clamping members being provided with interengageable means for aligning said needles with said sockets, stop means securing one of said clamping members against axial movement in one direction on said tube, and manually operated means including said tube for establishing axial adjustment of said other clamping member relative to said one clamping member so secured.
  • a pair of opposed clamping members each having an annular clamping face and a central bore, the clamping face of one of said members being provided with a plurality of projecting annularly spaced needles and the clamping face of the other of said members being provided with a plurality of annularly spaced sockets to receive said needles, one of said members having a tubular extension concentric with the bore thereof and adapted to iit snugly within the bore of the other of said members, said extension including a longitudinal slot, a pin carried by said other clamping member and extending into the bore thereof to engage in saidslot, the angular locations of said pin and slot being such as to cause alignment of said needles and sockets when said pin is engaged in said slot, a tube extending through the bores of said clamping members, stop means securing one of said clamping members against axial movement in one direction on said tube, and manually QD- erated means including said tube for establishing axial adjustment of said other clamp
  • An anastomosis clamp comprising the combination of a tube having an exteriorly threaded end Vportion and an exterior stop member axially spaced from said end portion; a rst clamping member including an annular clamping face, a stop shoulder directed away from said face. and an axial boresaid rst clamping member being slidably positioned on said tube with its shoulder facing said stop member; and a second clamp member having an annular clamping face and an interiorlypthreaded axial bore, said second clamping member being threadably engaged over the exteriorly threaded end portion of said tube and having its face directed tow-ard' the face of said first clamping member; oneof seid clamping faces being provided with'a.

Description

May 19, 1953 E'. D. SUGARBAKER SURGICAL CLAMP Filed July 30, 1951 INVENTOR EV-ERETT D. SUGARBAKER,
BY f... VLM ATTORNEYSl Patented May 19,ry 1953 OFFICE SURGICAL CLAMP Everett D; Sugarbaker,` Jetterson City, Mo.' Application July 30, 1951,.seria1No. $9,245
.12 claims. (01.128-334)` This invention relates to surgical clamps and particularly to an improved recto-colic anastomosis clamp. i
It is highly desirable to carry out bowel anl.. astomoses by clamping together inturned portions of the bowel ends and maintaining the ends -so clamped until agglutination occurs. at 4the periphery of the-junction. This method, however, involves several diiculties. It is necessary that the bowel ends remain clamped for periods on the order of 7-10. days, and such periods are so long that obstruction of the bowel by the clamping means would be .highly dangerous because of the accumulation of infective material inthe bowel above the clamp. Also, application of the clamp, and manipulation of the clamp after it is applied,.have heretofore been exceedingly diicult. y
The present inventionprovides a rectocolic anastomosis clamp whereby the foregoing dif` I culties are overcome. In Aaccordance with the invention, the clamp is so constructed as to allow ready escape of the mucoid contents of the bowel when the clamp is.v in place. .The
dangerous accumulation of infective material is thus prevented, and the bowel may be irrigated if necessary. 4 y y The anastomosis clamp of the invention is also characterized by a combination of structural A features which make application and adjustment of the clamp far less diicult than has ybeen the case heretofore. The clampis adapted to be assembled within the bowel, with the parts of the clamp being inserted through the..anus,
the structure being such that positioning of: the severed ends of the bowelon the faces ofthe clamp is readily `and positively accomplished. According to the invention, clamping pressure is establishedand adjusted by manipulation ci assembled and in place to accomplish an anas-= tomosis of the lowery colon, the clamp being `shown in longitudinal section;
Fig. 2 is a side elevation offtheclamp, with the clamping members separated, partly in longitudinal section; u. Fig. 3 is an end view of the lower clamping j The lower clamping shank 4 having at one end an enlarged, poraber .2. -ben2 adjacent the clamping faceIZ is a pin I5 and, .toreceivejthe pin l5, the tubular ele- .ment Illfof themember I is provided withone or more longitudinal slots Iopen at' the end member-showing the clamping face thereof; andV Fig. liv-is an'en'd- View of the upperclamping member.
Referring now to the drawings in detail, it
member 2, and Va central tube 3 adapted to coact with I and 2. v
member I includes a tion 5 with a transverse shoulder t` andatthe 'other end a vbody 'I withan annular clamping iace, Fig. 3.` The clamping. member I .is ,t u, bular, being provided With an axial bore` 9 extending entirely throug-h the member. Arranged coaxially with the bore 9 is a tubular extension I0 directed-.away fromthe clamping face 3.-y Thus, the lclamping. member I' comprises .a generally tubular memberwith thebody .lconstituting an intermediate outer enlargement.
The upper clamping member 2 comprises a.
Vbody II havingan annular lclamping face I2 -and'an vaxial bore I3. A portionpf. the bore I.3 is interiorly. threaded at I4, and the bore .adjacent theclamping face I2 has a diameter such that .the tubular element I0 ofthe lower clamping. member I -may slide into and .t snugly within thebore of the .clamping mem- Extending into the bore I3 of the inemf portion capable .of being inserted through the bores 9 and.v I3 andhaving at one end an enlarged por-tion Il presenting a transverse shoulder `...IILand .at the Aother end an exteriorly threaded portion i9.
. As seenin Fig.,.1, when the clamp is assembled.. the clamping member I is carried on the tube l3, `being secured against. axial movement in one direction lby contact Ybetween the'shoulv-ders .iiA and'I. The interior threads I4 ofthe clamping member 2 engage the exterior threads I9 of .the tube 3,.,so that relative rotary motionbetween -the tube 3 and the member 2 will cause the latter .to be adjusted either toward ing upon the direction of rotation. It will be noted that,- when the pin I5 is engaged in vone of the slotsdi the clamping members I-and 2 may not rotate relative to each other. When ably positioned'uponsaidrtube with said 'shoulder facing saidstopjmember;l `a second clanlping` member comprising ;a 'body; portion having an" annular clamping face and an interiorlythread'ed axial bore, said second clamping 4merriber' being positioned onl said tube with its vinterinr threads engaging theexterior threads of said tubeI andv with its4 clamping face directed toward' that oi said first clamping rmernb'eriwhereby relative rotation between said tube and said second clamping member in one direction forces said clamping faces together;v -andmeans-for securing a severed bowel ed over each of said clamping faces when said faces are spaced apart.
4. In a recto-colic anastomosis clamp, the combination of a pair of opposed clamping members each having an .annular clamping faceand an axial bore, one of ,said vclamping `members having an extended shank terminating' in a transverse shoulder opposite the clamping face thereof, the bore of the other of said clamping members being interiorly threaded, and a central tube'extending through the bore of said one clamping member and terminating at one end in an exteriorly threaded portion engaging the interior threads of the bore of said other clamping member, said tube being provided at its other end with an exteriorly positioned stop member facing the transverse shoulder of said one clamping member, and said shank being of such length as to extend through the rectum of a patient when saidclamp is in place within the colon.
5. In an anastomosis clamp, the combination of a central tube having at one end an exteriorly enlarged portion providing a transverse shoulder facing the opposite end of the tube, and a pair of opposed clamping members each having an annular clamping face and an axial bore, said tube being positioned within the bores of said clamping members, one of said clamping members .being provided with a transverse shoulder opposite its clamping face and facing the shoulder of said tube, and said tube and the other of said clamping members having interengaging screw threads.
6. In an anastomosis clamp, the combination of a tube having an exteriorly threaded end portion and an exterior shoulder spaced axially from said end portion; a clamping member having a shank, a body portion with an annular clamping face and an axial bore extending through said shank and body portion, said clamping member being slidably mounted on said tube with the shank thereof extending toward said shoulder and said clamping face exposed toward the threaded end of said tube; and a second clamping member having an annular clamping face and a threaded axial bore, said second clamping member being threaded upon said end portion of said tube with its clamping face opposed to that of said first mentioned clamping member.
7. An anastomosis clamp comprising a tubular clamping member with an intermediate exteriorly enlarged portion having an annular clamping face arranged transversely of said'tubular member and exposed toward one end thereof; a second clamping member having a transverse annular-clamping face and an axial bore, said bore adjacent said last mentioned clamping face embracing said one end of said tubular clamping member, said bore also including an interiorly threaded portion; and a central tube extending through said tubular clamping member, said tube having at one end an exterior stop facing said tubular clamping member and at the other end aV portion' exteriorly threaded in ,engagement with the; interior threads of said bore'. H
' '8.'In an anastomosis clamp, a pair o f opposed clampingI membersv "each having an annular clamping face and a central bore, the clamping face 'of one of said members lbeing'prc'nvided with a plurality of projecting annularly ,spacedfneedles and the clamping face of 'the other of rsaidfmembersI being providedwitl apluralityof 4annular-- ly spaced sockets to-rec'eive said needles, one of said clamping lmembers 'having a shoulder 'opposite the clamping `face thereof, theother of said clamping'membe'rs being interiorlyfthreaded', and a tube :extending through said bores, said tube havinguatzoneren'da shoulder facing the shoulder on Vsaid onefclampingmember and at the other. end 'jbeing provided" with exterior threads `engaging the' interiorf threads `of said other clamping member;
'9. In an anastomosis clamp, the combination of a pair of opposed clamping members each having an -annular clamping face and an axial bore, the clamping face of one of said members being provided With a. plurality of projecting annularly spaced needles and the other of said members being provided with a plurality of annularly spaced sockets to receive said needles, a central tube extending through the bores of said clamping members, stop means securing one of said clamping members against axial movement in one direction on said tube, and manually operated means including said tube for establishing axial adjustment of said other clamping member relative to said one clamping member so secured.
10. In an anastomosis clamp, the combination of a pair of opposed clamping members each having an annular clamping face and an axial bore, the clamping face of one of said members being provided with a plurality of projecting annularly spaced needles and the clamping face of the other of said members being provided with a plurality of annularly spaced sockets to receive said needles, a central tube extending through the bores of said clamping members with one of said members rotatable thereon, said clamping members being provided with interengageable means for aligning said needles with said sockets, stop means securing one of said clamping members against axial movement in one direction on said tube, and manually operated means including said tube for establishing axial adjustment of said other clamping member relative to said one clamping member so secured.
11. In combination in an anastomosis clamp of the type described, a pair of opposed clamping members each having an annular clamping face and a central bore, the clamping face of one of said members being provided with a plurality of projecting annularly spaced needles and the clamping face of the other of said members being provided with a plurality of annularly spaced sockets to receive said needles, one of said members having a tubular extension concentric with the bore thereof and adapted to iit snugly within the bore of the other of said members, said extension including a longitudinal slot, a pin carried by said other clamping member and extending into the bore thereof to engage in saidslot, the angular locations of said pin and slot being such as to cause alignment of said needles and sockets when said pin is engaged in said slot, a tube extending through the bores of said clamping members, stop means securing one of said clamping members against axial movement in one direction on said tube, and manually QD- erated means including said tube for establishing axial adjustment of said other clamping member relative to said one clamping-member .so secured. l
` i2. An anastomosis clamp comprising the combination of a tube having an exteriorly threaded end Vportion and an exterior stop member axially spaced from said end portion; a rst clamping member including an annular clamping face, a stop shoulder directed away from said face. and an axial boresaid rst clamping member being slidably positioned on said tube with its shoulder facing said stop member; and a second clamp member having an annular clamping face and an interiorlypthreaded axial bore, said second clamping member being threadably engaged over the exteriorly threaded end portion of said tube and having its face directed tow-ard' the face of said first clamping member; oneof seid clamping faces being provided with'a. plurality of projecting annularly spaced'` Aneedles and the other of said clamping. faces being provided with a plurality of annularlyspaced socketsl to receive said needles, and said clamping members being provided with interengageable means for aligning said needles and sockets.
EVERETT D. SUGARBAKER.
References cited in the me of this patent UNITED STATES PATENTS Name Date l Zack Nov. 2, 1948 OTHER REFERENCES Number
US239245A 1951-07-30 1951-07-30 Surgical clamp Expired - Lifetime US2638901A (en)

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US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
US11723658B2 (en) 2021-03-22 2023-08-15 Cilag Gmbh International Staple cartridge comprising a firing lockout
US11737749B2 (en) 2021-03-22 2023-08-29 Cilag Gmbh International Surgical stapling instrument comprising a retraction system
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
US11717291B2 (en) 2021-03-22 2023-08-08 Cilag Gmbh International Staple cartridge comprising staples configured to apply different tissue compression
US11944336B2 (en) 2021-03-24 2024-04-02 Cilag Gmbh International Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
US11793516B2 (en) 2021-03-24 2023-10-24 Cilag Gmbh International Surgical staple cartridge comprising longitudinal support beam
US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US11744603B2 (en) 2021-03-24 2023-09-05 Cilag Gmbh International Multi-axis pivot joints for surgical instruments and methods for manufacturing same
US11786243B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Firing members having flexible portions for adapting to a load during a surgical firing stroke
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11832816B2 (en) 2021-03-24 2023-12-05 Cilag Gmbh International Surgical stapling assembly comprising nonplanar staples and planar staples
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11826047B2 (en) 2021-05-28 2023-11-28 Cilag Gmbh International Stapling instrument comprising jaw mounts
US11918217B2 (en) 2021-05-28 2024-03-05 Cilag Gmbh International Stapling instrument comprising a staple cartridge insertion stop
US11723662B2 (en) 2021-05-28 2023-08-15 Cilag Gmbh International Stapling instrument comprising an articulation control display
US11877745B2 (en) 2021-10-18 2024-01-23 Cilag Gmbh International Surgical stapling assembly having longitudinally-repeating staple leg clusters
US11937816B2 (en) 2021-10-28 2024-03-26 Cilag Gmbh International Electrical lead arrangements for surgical instruments

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